Mastodynia (breast pain) is the second most common breast symptom for which women seek a medical consultation. Because of the fear of breast cancer, mastodynia is a symptom of great concern to women. Although mastodynia is usually related to a benign condition, breast cancer may also manifest with pain as its initial symptom. Pain is reported to be associated with breast cancer in 8%–10% of all breast cancer cases.

OVERVIEW OF MASTODYNIA

Mastodynia can be cyclic or noncyclic.

Cyclic Mastodynia

Cyclic mastodynia is the most common type of breast pain. It is the result of water retention during the luteal phase of the menstrual cycle, which causes edema in the connective tissue. Characteristically, the pain is bilateral, occurs in the last two weeks of the cycle, and subsides at the start of menstruation.

In general, the severity of the symptom is related to the amount of swelling and the patient's threshold for pain. The pain is not actually localized; however, it frequently presents in the upper outer quadrant of the breast, which is the location of most of the breast parenchyma.

Cyclic pain – described as “heaviness,” “aching,” or “soreness” – is more common in women between the ages of 30 years and 35 years. Some patients may describe the pain as radiating toward the axilla and the inner surface of the arm, following the sensory branch distribution of the intercostal nerves.